Experience of using anti-CD 20 therapies in multiple sclerosis patients in Kenya.

Objective: The objective of the study was to evaluate the safety and efficacy of ocrelizumab (OCR) and rituximab (RTX) in multiple sclerosis. Methods: This was a retrospective single-centre study. Ocrelizumab- and rituximab-treated patients were identified through the multiple sclerosis (MS) registry maintained at Aga Khan University Hospital Nairobi (AKUHN), Kenya. Adult patients aged 18-65 years old who fulfilled the McDonald 2017 diagnosis criteria and received treatment with either rituximab or ocrelizumab between January 2016 and June 2025 were retrospectively evaluated. Data collected at baseline included age, gender, first symptoms, disease duration since onset, MS phenotype, treatment duration, previous therapies, reasons for switching to anti-CD 20 (cluster of differentiation) therapy, date of start of anti-CD 20 therapy, and adverse events. Disease activity was evaluated both clinically and through magnetic resonance imaging (MRI). Results: A total of 67 patients (male:female, 14:53) received anti-CD 20 therapy, with the majority having relapsing-remitting MS (RRMS) (5277.6%), while the rest had progressive MS. Patients were treated with either ocrelizumab 600 mg or rituximab 1,000 mg administered intravenously (IV) every 6 months. After 1 year, the cumulative relapse rate dropped, with the number of patients having clinical relapse events reduced from 48 to 7. Overall, 40 patients had stable MRI findings, 7 had new MRI lesions, and 20 did not have follow-up scans. No infusion-related adverse events or life-threatening infections were reported with the administration of anti-CD 20 therapy, and no case of malignancy or progressive multifocal encephalopathy was detected. Conclusion: This retrospective, single-centre study provides real-world data on B-cell-depleting therapies in an African MS cohort. Ocrelizumab and rituximab appear to be safe, well-tolerated, and effective therapeutic options for people living with MS.